Introduction: Spatial navigation, the ability to move through one’s environment, is a complex skill utilized in everyday life. The effects of specific vestibular end-organ deficits and hearing impairments on spatial navigation have received little to no attention. We hypothesized that hearing impairment adversely affects spatial navigation and that bimodal impairments (vestibular and hearing) further impair navigation ability. Methods: Data from 182 participants in the Baltimore Longitudinal Study of Aging who had interpretable results for the video head impulse test (vHIT), cervical vestibular evoked myogenic potentials (cVEMP) and ocular vestibular evoked myogenic potentials (oVEMP), audiometric testing, and the triangle completion test (TCT) were retrospectively analyzed. Multiple linear regression, controlling for age, sex, and cognition, was employed to identify predictors of TCT performance in terms of end-point error, angle deviation, and distance walked. Results: oVEMP abnormalities were associated with larger end-point error (p = 0.008) and larger angle deviation (p = 0.002) but were not associated with distance walked (p = 0.392). Abnormalities on cVEMP testing and vHIT were not associated with distance walked (p = 0.835, p = 0.300), end-point error (p = 0.256, p = 0.808), or angle deviation (p = 0.192, p = 0.966). Compared with normal-hearing adults, hearing-impaired adults walked a shorter distance during the TCT (p = 0.049) but had a similar end-point error (p = 0.302) and angle deviation (p = 0.466). There was no interaction between vestibular and hearing function for predicting spatial navigation ability. Conclusion: In this cohort analysis, utricular dysfunction and hearing impairment were associated with poorer spatial navigation performance. We postulate that hearing impairment negatively affects one’s ability to use real-time, intrinsic auditory cues and/or prior experience to guide navigation.

Spatial navigation, the ability to move through one’s environment, is a complex skill utilized in everyday life. The effects of specific balance and hearing deficits on spatial navigation have not been extensively studied. Thus, we analyzed data from 182 participants in the Baltimore Longitudinal Study of Aging who completed balance, hearing, and spatial navigation tests to determine if hearing impairment may adversely affect spatial navigation and if combined deficits in balance and hearing further impair navigation ability. Our analyses accounted for the confounding effects of age, sex, and cognition on aspects of spatial navigation performance. We found that deficits in hearing and in the balance organ that senses horizontal translational movements were associated with worse performance on spatial navigation. However, deficits in the balance organs that sense vertical translational movements and horizontal rotational movements were not associated with worse spatial navigation ability. Surprisingly, we found that those with combined balance and hearing deficits did not perform significantly worse on spatial navigation than those with deficits in either balance or hearing alone. We believe that the abnormal function of the horizontal translational movement sensors likely explains the gait disorientation experienced by persons with inner ear problems. Additionally, we propose that hearing deficits impede one’s ability to use real-time sound cues to guide navigation. Many of our participants had mild deficits; thus, further research on the effects of more severe balance and hearing deficits on spatial navigation is needed to gain a better understanding of how different sensory inputs contribute to spatial navigation ability.

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